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Background: Even though a few years have passed since the coronavirus disease 2019 (COVID-19) outbreak, information regarding certain aspects of the disease, such as post-infection immunity, is still quite limited. This study aimed to evaluate post-infection protection and COVID-19 features among healthcare workers (HCWs), during three successive surges, as well as the rate of severe acute respiratory syndrome coronavirus 2 (SARS- CoV-2) reinfection, reactivation, re-positivity, and severity. Methods: This cross-sectional population-level observational study was conducted from 20 April 2020 to 18 February 2021. The study population included all HCWs in public or private hospitals in Fars Province, Southern Iran. The infection rate was computed as the number of individuals with positive polymerase chain reaction (PCR) tests divided by the total number of person- days at risk. The re-infection was evaluated after 90 days. Results: A total of 30,546 PCR tests were performed among HCWs, of which 13,749 (61.94% of total HCWs) were positive. Considering the applied 90-day threshold, there were 44 (31.2%) cases of reactivation and relapse, and 97 (68.8% of infected and 1.81% of total HCWs) cases of reinfection among 141 (2.64%) diagnosed cases who experienced a second episode of COVID-19. There was no significant difference in symptoms (P=0.65) or the necessity for ICU admission (P=0.25). The estimated protection against repeated infection after a previous SARS- CoV-2 infection was 94.8% (95% CI=93.6-95.7). Conclusion: SARS-CoV-2 re-positivity, relapse, and reinfection were rare in the HCW population. After the first episode of infection, an estimated 94.8% protection against recurring infections was achieved. A preprint version of this manuscript is available at DOI: 10.21203/rs.3.rs-772662/v1 (https://www.researchsquare.com/ article/rs-772662/v1). [ABSTRACT FROM AUTHOR]

Background: Previous research has shown the impact of pandemic communicable diseases on the mental health of healthcare providers. This study examined the relationship between general health, spiritual health, anxiety associated with COVID-19, job satisfaction, and the mediating role of sex in healthcare providers in Iran in 2021. Methods: This was a descriptive-analytical and cross-sectional study performed on 163 healthcare providers of which 71.8% were female and 28.2% were male with an age range between 21 and 58 years, an average work experience of 9.5 years, and working as nurses, doctors, laboratory technicians, etc. in some hospitals in Sanandaj. Data were collected using COVID-19 Anxiety, General Health, job satisfaction, and Spiritual Health questionnaires. Then, the data were analyzed using SPSS-22 software, regression test, and path analysis. Results: Although women averaged lower levels of general health, job satisfaction, and anxiety associated with COVID-19, and higher scores in spiritual health than men, none of these differences were statistically significant, and sex didn't play a significant role here. Also, general health and spiritual health could significantly predict 17.1% of the variance in job satisfaction in the path analysis. However, sex and Covid-19 anxiety could not significantly predict this variable. Conclusion: The results showed that there was not a significant difference between the male and female workers' general health when facing such pandemics. However, we may prepare interventions to promote their general and spiritual health and to promote healthcare providers' job satisfaction during such pandemics. [ABSTRACT FROM AUTHOR]

Background: Studies in different communities have shown significant differences in IgG antibody titers in the time period after the first and second doses of the vaccines. This study aimed to serologically evaluate the IgG anti-spike antibody titer five months after injection of the second COVID-19 vaccine in healthcare workers. Materials and method: This study was performed in healthcare personnel for whom five months had passed since their second anti-Covid-19 vaccination. The level of IgG antibody against SARS-CoV-2 spike protein was measured by ELISA. Healthcare workers in Mofid Children's hospital received three brands of vaccines: Sputnik V, Sinopharm, and AstraZeneca. Results: The mean titer of anti-spike IgG was 4.3±2.29 units. The percentage of positive cases of the antibody was estimated to be 96.4%. The titer of anti-spike IgG antibody was dependent on both the occupational area and a positive history of Covid-19 disease. Conclusion: About 96.4% of the staff vaccinated against Covid-19 had a high titer of anti-spike IgG antibody even five months after inoculation of the second dose. The field of occupational can affect the level of antibody present [ABSTRACT FROM AUTHOR]

The pandemic of COVID-19 has had a negative impact on healthcare providers. Resilience is thought to protect against mental illnesses and to help people cope with stress more effectively. The purpose of this research is to determine the relationship between resilience and anxiety in healthcare workers during the COVID-19 pandemic. A cross-sectional online survey was carried out on 184 eligible healthcare workers recruited from health centers in Bushehr and Borazjan cities. Data collection was performed using standard questionnaires that consist of sociodemographic and COVID-19-related information, the Corona Disease Anxiety Scale, and the Connor-Davidson Resilience Scale. The data were analyzed using SPSS software and descriptive statistics. The Mann–Whitney U test, Independet Sample t-test, Kruskal–Wallis , and Spearman correlation test were applied for analyzing data. Statistical significance was set at a P-value of < 0.05. The age mean of the participants was 35.54 ± 7.11, and 40% of them experienced moderate and high levels of anxiety. Significant negative relationship was found between anxiety and resilience (r = − 0.211, p = 0.032). Those who experienced death from COVID-19 in family or friends were more anxious than their counterparts (p = 0.004). This study showed more than one-third of the participants experienced moderate and high levels of anxiety in response to the COVID-19 pandemic. Anxiety was found to be related to resilience, and the greater the resilience, the lower the overall anxiety score. In policy development, this can be used to improve the resilience of healthcare workers and prevent mental health illnesses. [ABSTRACT FROM AUTHOR]

Objective: COVID-19, which is an international concern by far, had fundamental impacts on mental health of medical staff. Healthcare workers are the high-risk group to endure the emotional outcomes brought about by the outbreak. This study assesses the mental consequences of healthcare workers during the acute phase of COVID-19 pandemic in Tehran. Method: We conducted a cross-sectional study on healthcare workers from two tertiary referral hospitals in Tehran province. A total of 222 of the staff participated in the study. Our questionnaires comprised Impact of Event Scale- Revised (IES-R) and 12-item General Health Questionnaire (GHQ-12), which were handed to participants to obtain data on their general mental problems in addition to the psychological impacts of the evolving virus on this particular group. Epidemiologic and sociodemographic information of participants, level of perceiving exposure to disease, and underlying diseases of each of them were gathered during the recruitment period. Results: Results showed high probabilities (98.2%) in mental disorders among healthcare workers. Since our study was done during the initial phase of the pandemic, development of mental issues due to the newly emerged infectious virus was expected. However, we recorded mild (41.4%) to moderate (31.5%) impact of this novel virus. The possibility of having mental problems was much higher in females, assistant nurses, individuals with lower education, and those who provided care for COVID-19 patients. Conclusion: COVID-19 has brought about increased distress among healthcare workers. Noticeably, the forefront group in combating this virus bear the most emotional complications. Thus, efforts should be taken into practice to provide proper psychological support for this vulnerable group. [ABSTRACT FROM AUTHOR]

Background: Having good quality of sleep is essential to good health. Sleep disorders could incur intangible expenses. The aim of this cross-sectional study was to evaluate the Persian version of the Pittsburgh Sleep Quality Index (PSQI-P) questionnaire administered to 3 categories of workers (clinical personnel, clerical staff, and logistics workers) in a private hospital located in Tehran, Iran. Methods: In 2017, all Pars hospital personnel were invited to participate in the study. The PSQI-P questionnaire was distributed among Pars hospital staff, who consented to take part in the study. Results: The total personnel in this private hospital was 1151 and 552 of them submitted their answers. According to the statistical analysis performed using SPSS version 19, there was no correlation between sleep quality and gender, marital status, age, job, shift work, or university degree (P value: 0.94, 0.42, 0.59, 0.67, 0.12, 0.23, respectively). However, participants with a lower body mass index (BMI) experienced better overnight sleep quality than overweight and obese participants (P value: 0.025 and 0.032, respectively). In addition, the prevalence of poor sleep quality was higher in those living in the suburbs compared to urban residents (P value: 0.02). Conclusion: The study obtained a significant difference in sleep quality based on the participants' BMI and place of residence. Despite the fact that the P value of the job was not significant, it appeared that sleep disorders are common among clinical personnel. Quality of life may be improved by modification of the factors responsible for poor sleep quality. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has burdened disastrous mortality and morbidity rates in society all over the world. While vaccination is one of the most effective immunization methods to control infectious diseases globally, some have avoided receiving the vaccine. We have aimed to investigate the reasons behind the hesitancy of vaccination among healthcare workers. We performed ten semi-structured interviews with volunteered healthcare workers of Rasoul Akram hospital. Then each interview was anonymized, and Braun and Clarke's thematic analysis method was used to analyze the interviews. Our data analysis revealed thirty-eight different codes as reasons for vaccination hesitancy among our interviewees. All these thirty-eight codes were grouped into ten sub-themes, and these sub-themes were further grouped into our four main themes: 1. Fear of side effects, 2. Distrust, 3. Inefficiency, and 4. Non-necessity. Fear of side effects was the most frequent reason that interviewees mentioned. Also, Half of the interviewees mentioned distrust as a reason for COVID-19 vaccine hesitancy. At least once, all interviewees mentioned that they believed vaccination is inefficient. Some interviewees had beliefs and reasons that made them assume vaccination is simply not necessary. Fear of side effects, distrust, inefficiency, and non-necessity were the reasons that our participants refused to get vaccinated. Fear of side effects and distrust were the most common reasons that led to non-vaccination. • Fear of side effects, distrust, inefficiency and non-necessity are the reasons for COVID-19 vaccination hesitancy among HCWs. • Fear of side effects is the main reason for COVID-19 vaccination hesitancy. • unlike other antivaccination movements, the main cause of COVID-19 vaccination hesitancy is not conspiracy theory. [ABSTRACT FROM AUTHOR]

Background/aims: The aim of this study was to determine the rate of natural and breakthrough infection and related symptoms of Covid-19 amongst Iranian healthcare workers (HCWs) who were vaccinated by different non-mRNA-based vaccines at peak points., Methods: In this cross-sectional study, the RT-PCR test was performed for a total of 10,581 HCWs suspicious of Covid-19 infection. For each HCW, the frequency of SARS-CoV-2 infection and the time of transmission based on vaccination administration time and schedule were examined during different waves of the pandemic. Based on these findings, the study patients were divided into three groups: natural, natural/breakthrough, and breakthrough., Results: In total, 53% of the HCWs were exposed to SARS-CoV-2 infection between 1 and 5 times within two years after the current pandemic, while 20.7% and 32.3% experienced natural and breakthrough SARS-CoV-2 infection, respectively. Only 6% of the breakthrough-infected HCWs had naturally contracted SARS-CoV-2 infection during the initial waves. The highest natural peaks of infection occurred during the interval administration of the first and second dose of the first vaccination series, while the single highest peak of breakthrough infection belonged to the Omicron wave. It occurred simultaneously with the administration of the third vaccination dose. On the other hand, the highest rate of reinfection was observed amongst people who had received the Sinopharm and Bharat vaccines full-doses., Conclusion: This study compared the clinical differences between the two peaks of Omicron and Delta. This study indicates the rates of natural and breakthrough SARS-CoV-2 infections according to vaccination schedules and different waves of the pandemic., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Purpose: This study aimed to assess the frequency of sleep and mood disturbances, and their association with COVID-like symptoms in healthcare workers (HCWs) with and without positive Coronavirus RT-PCR in a corona referral center., Methods: This study was a cross-sectional, anonymous survey of adult HCWs. Data collection was performed in May and June 2020, while governmental restrictions were in place. The participants completed the forms including six separate parts: personal and occupational information, Insomnia Severity Index (ISI), Generalized Anxiety Disorder-7 (GAD-7), Patient's Health Questionnaire (PHQ-9), Pittsburgh Sleep Quality Index (PSQI), and COVID-like symptoms and Coronavirus RT-PCR status., Results: Among the 372 HCW participants, 245 (66%) were women and  mean age was 34.5 ± 7.1 years (age range 23 to 58). The mean scores of all questionnaires except ISI were significantly higher in the HCWs with positive Coronavirus RT-PCR than another group (PSQI, 9 ± 3.4 vs. 6.9 ± 3.1; GAD-7, 9.8 ± 3.6 vs. 7.9 ± 5.3; PHQ-9, 12.8 ± 6.1 vs. 9.5 ± 6.4, P < 0.05; and ISI, 13.8 ± 5.3 vs. 12.3 ± 6 P = 0.163). Positive association between COVID-like symptoms and sleep and mood disturbances was found in the group without a positive test result. Analysis of questionnaires showed higher scores in the group directly involved except for ISI (P < 0.001 and P = 0.053 respectively)., Conclusions: During the COVID-19 pandemic, the HCWs in this sample experienced a high rate of sleep and mood disturbances. There was also a strong association between sleep and mood disturbances and COVID-like symptoms in the group without a positive RT-PCR result. With all this considered, effective psychological support for HCWs during crisis seems to be necessary., (© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG part of Springer Nature.)

The vulnerability of employees of different occupations from the Coronavirus disease 2019 (COVID-19) pandemic in Iran was assessed using an innovative index. The vulnerability index was developed in five steps as follows: (1) determining the principles and components of employees' susceptibility and resilience, (2) weighting the principles and components, (3) converting the levels of components to the sub-index values, (4) introducing the aggregation functions, and (5) characterizing the vulnerability index values in five categories as very high (80–100), high (65–79), medium (50–64), low (30–49), and very low (0–29). The average values of susceptibility, resilience, and vulnerability index of the employees were determined to be 35.2 ± 15.0, 73.9 ± 17.0, and 32.9 ± 12.7, respectively. The average resilience of the employees was more desirable than their average susceptibility. The distribution of the employees into the vulnerability index categories was 46.3% for very low, 41.9% for low, 3.6% for medium, and 8.2% for high. The worst cases of susceptibility and resilience principles were exposure to contaminated surfaces (59.1 ± 22.8) and top management commitment (66.6 ± 23.1). The elderly staff (especially over 50 years old), employees with low education levels, and employees in private and self-employment sectors were significantly more vulnerable (p value < 0.01) from the COVID-19 pandemic. The principles with significant incremental effects on the vulnerability index (p value < 0.05) were respectively top management commitment (+1.78), exposure to COVID-19 patients at work (+1.36), exposure to contaminated surfaces (+0.82), installing clear shields and wearing PPE (+0.59), observance of social distancing (+0.48), and just culture (+0.22). An especial plan to support the more vulnerable employees with an emphasis on the principles with the most incremental effects on the vulnerability index can efficiently control the inequality between the employees as well as occupational transmission of the COVID-19 in Iran. • The vulnerability of employees from the COVID-19 pandemic in Iran was assessed. • The vulnerability of 8.2% of employees from the COVID-19 pandemic was high. • The worst case of susceptibility principles was exposure to contaminated surfaces. • The worst case of resilience principles was top management commitment. • The most vulnerable employees and most effective interventions were introduced. [ABSTRACT FROM AUTHOR]

Aim: The outbreak of COVID-19 has laid unprecedented psychological stress on healthcare workers (HCWs). We aimed to assess the immediate psychological impact of COVID-19 epidemic on the HCWs at Baqiyatallah Hospital in Tehran, Iran., Material and Methods: We conducted a cross-sectional survey of HCWs using questionnaires in February and March 2020 in Baqiyatallah Hospital, Tehran. We evaluated depression, stress, and anxiety levels using the DASS-21 questionnaire. Participants were selected by using census sampling. All statistical analyses were performed using R version 3.5.1., Results: The study population included 217 HCWs (111 male, 116 female) and the mean age of the study group was 39.6 years old. Approximately two-thirds of the HCWs stayed in the hospital for 2-3 weeks. The mean scores of depression and stress were at a "severe" level, while anxiety scores were at an "extremely severe" level. The prevalence of severe scores was 38.71%, 2.30%, and 48.97% for depression, anxiety, and stress, and the prevalence of extremely severe scores was 46.54%, 97.24%, and 4.98% depression, anxiety, and stress, respectively. In stress subscale, moderate stress was 47.46%. Female HCWs reported higher levels of depression compared with males., Conclusion: In this study, HCWs reported experiencing severe and extremely severe psychological burdens. Timely interventions to promote mental health in HCWs exposed to patients with COVID-19 need to be immediately implemented, with female nurses requiring particular attention. This process could be facilitated via tests for molecular biomarkers in accessible body fluids, such as saliva, plasma, and serum.

Introduction: Low job satisfaction among healthcare workers may lead to high turnover intention, poor job performance, high absenteeism, and low patient satisfaction. Global and local needs for health workforce are increasing in trend to meet current health demands. Addressing job satisfaction of the healthcare workers is a practical way to utilise the available human resources optimally. The main aim of this study is to determine job satisfaction level and its associated factors among healthcare workers in health clinics under the Petaling District Health Office jurisdiction in Selangor, Malaysia. Methods: A cross-sectional study was conducted among healthcare workers in ten health clinics in Petaling District from April until May 2019. Simple random sampling method proportionate to the number of staffs from each health clinics was done. A structured self-administered questionnaire was used. Results: The response rate was 93%. Majority of the respondent were female (83%), married (82%), diploma holder (41%), nurses (33%) and working in health clinics with specialists (93%). The job satisfaction mean score for the studied population was 4.46 (SD = 0.72). Self-rated physical health and mental stress status were significantly associated with job satisfaction (p < 0.001). Conclusion: The job satisfaction level of the studied population was comparable to other local studies and higher than studies from Iran, Ethiopia and China. Extra attention should be given to healthcare workers with poor physical health and poor mental stress. More objective study on physical health and mental stress is required. [ABSTRACT FROM AUTHOR]